Unequal Access To Breast‐Conserving Surgery In Western Australia 1982–;2000

Hall, Sonĵa E.; Holman, C. DʼArcy J.; Hendrie, Delia; Spilsbury, Katrina

doi:10.1111/j.1445-1433.2004.03020.x

Cited by 39 publications

(48 citation statements)

References 34 publications

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“…While it has been shown that Western Australian women of lower socioeconomic status were more likely to have a mastectomy as their initial surgery compared to other women 30 and that socioeconomic status has been associated with poorer survival in the US and UK, 10,31,32 there was no evidence in this study that socioeconomic status affected survival outcomes from breast cancer after adjusting for other demographic, treatment and hospital-related factors. A similar observation was made for Aboriginal women compared to non-Aboriginal women, although the very small numbers of Aboriginal women in the present study weakened the power to detect small survival differences.…”

Section: Discussioncontrasting

confidence: 61%

Long‐term survival outcomes following breast cancer surgery in Western Australia

Spilsbury

Semmens

Saunders

et al. 2005

ANZ Journal of Surgery

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Section: Discussioncontrasting

confidence: 61%

Long‐term survival outcomes following breast cancer surgery in Western Australia

Spilsbury

Semmens

Saunders

et al. 2005

ANZ Journal of Surgery

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“…Their study findings suggest that there are clusters of high heart-related utilisation rates within the state and that these are prominent in more rural counties. In other studies the impact of travel times on the utilisation of health services has been investigated (together with factors such as age and deprivation) with often contradictory findings; for example in relation to the utilisation of breast-conserving surgery and travel times to radiotherapy (Hall et al 2004;Schroen et al 2005;Sauerzapf et al 2008) although the importance of context such as policies towards healthcare and also key differences in methodological approach in such studies have been re-iterated (Sauerzapf et al 2008).…”

Section: Discussionmentioning

confidence: 97%

The role of GIS for health utilization studies: literature review

Higgs

2009

Health Serv Outcomes Res Method

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There have been a plethora of studies investigating access issues in relation to health services but until recently a relative lack of research on geographical factors that may be influencing utilisation patterns. This paper includes a timely review on what is known from existing studies, a description of the main methodological concerns highlighted by such studies and draws on the review to present some ideas for more research in this area. The use of Geographical Information Systems (GIS) in investigating the relative importance of geographical factors on utilisation patterns is advocated through a review of published studies and a call made for more research to examine potential relationships with for example health outcomes. Recent advances with regard to the availability of detailed geographically disaggregate data and new location-based techniques such as developments in Global Positioning Systems (GPS) hold out great promise in such regards. Finally the policy relevance of such studies is re-iterated in terms of helping to tackle perceived inequities in the system, addressing health inequalities as well as gauging the effectiveness of current and planned service configurations.

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“…3 Various factors can influence whether women receive BCS or mastectomy. 4, 5 Comorbidity, the coexistence of chronic diseases or acute illnesses in addition to the index disease, may influence the selection and timing of treatment.…”

Section: Introductionmentioning

confidence: 99%

Breast conserving surgery versus mastectomy: the influence of comorbidities on choice of surgical operation in the Department of Defense health care system

Zhou¹,

Enewold²,

Zahm³

et al. 2013

The American Journal of Surgery

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BACKGROUND Studies on the effect of comorbidities on breast cancer operation have been limited and inconsistent. This study investigated whether pre-existing comorbidities influenced breast cancer surgical operation in an equal access healthcare system. METHODS This study was based on linked Department of Defense cancer registry and medical claims data. The study subjects were patients diagnosed with stage I–III breast cancer during 2001 to 2007. Logistic regression was used to determine if comorbidity was associated with operation type and time between diagnosis and operation. RESULTS Breast cancer patients with comorbidities were more likely to receive mastectomy (OR=1.27, 95% CI, 1.14–1.42) than breast conserving surgery plus radiation. Patients with comorbidities were also more likely to delay having operation than those without comorbidities (OR=1.27, 95% CI, 1.14–1.41). CONCLUSIONS In an equal access healthcare system, comorbidity was associated with having a mastectomy and with a delay in undergoing operation.

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Unequal Access To Breast‐Conserving Surgery In Western Australia 1982–;2000

Abstract: Several factors were found to affect the likelihood of women with breast cancer receiving breast-conserving surgery, in particular, women from disadvantaged backgrounds were significantly less likely to receive breast-conserving surgery than those from more privileged groups.

Cited by 39 publications

References 34 publications

Long‐term survival outcomes following breast cancer surgery in Western Australia

Long‐term survival outcomes following breast cancer surgery in Western Australia

The role of GIS for health utilization studies: literature review

Breast conserving surgery versus mastectomy: the influence of comorbidities on choice of surgical operation in the Department of Defense health care system

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